Step width increaser

ABSTRACT

The apparatus provides a proper step width for patients during gait training with neurological disorders, such as spasticity or paraparesis of the lower extremities. The apparatus provides proprioceptive feedback through the ankles during gait training with an assistive device (cane, walker, or parallel bars). The apparatus can be adjusted to different step widths depending on the patient and the physical therapist&#39;s recommendation. The result would be an improvement in the patient&#39;s gait pattern over time (with less risk of injury to the patient) and an improvement in the method used by the physical therapist for gait training for this problem.

CROSS REFERENCE TO RELATED APPLICATIONS

Not Applicable

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

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REFERENCE TO A SEQUENCE LISTING, A TABLE, OR A COMPUTER PROGRAM LISTING COMPACT DISC APPENDIX

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BACKGROUND OF THE INVENTION

This invention relates to rehabilitation equipment for the physical therapy field. More specifically, it relates to a portable apparatus which can be used in a clinic and/or a patient's home to assist in attempting to increase the step width of the patient.

BRIEF SUMMARY OF THE INVENTION

As a Licensed Physical Therapist Assistant in Massachusetts, I have spent a few years gait training the elderly using assistive devices (e.g. walkers and canes). Many of them ambulated with a very narrow base of support, or worse, displayed a scissoring gait pattern (this happens when the patient's feet cross over each other during gait as opposed to normal gait with the feet being parallel to each other). This could be caused by a few problems such as weak hip abductors, poor range of motion or spasticity in the hip adductors, internal hip rotation due to spasticity or tightness, or hemiplegia following a stroke. A crude (and unsafe) method of trying to prevent this occurrence during gait training is to place the foot of the therapist between the feet of the patient as he or she walks. This method, although used quite often, is not the safest. The patient is at risk for tripping and the physical therapist is assisting the patient with less than optimal stability.

I have created a device which would facilitate a normal step width during ambulation without disturbing the patient's balance or putting the physical therapist in a position of compromised stability. The device would have a fixture placed between the patient's ankles to maintain a normal step width (7-10 cm) as he or she walked. It would prevent the patient's step width from decreasing to less than 7-10 cm. The device would only be used during gait training with a licensed Physical Therapist or Physical Therapist Assistant.

BRIEF DESCRIPTION OF THE DRAWINGS (PHOTOGRAPHS)

The objectives and benefits of this apparatus will become apparent by referring to the following figures.

FIG. 1 is a view of 2 of the interlocking rubber mats with the Velcro® strip and 2 unfastened step width “separators” (bottom view and side view) of different widths: approximately 2¾ inches (7 centimeters) and 1½ inches (4 centimeters).

FIG. 2 is a top view of 2 joined interlocking rubber mats along with the 2¾ inch step width “separators” attached.

FIG. 3 is a closer view of 2 joined interlocking rubber mats along with the 2¾ inch step width “separators” attached.

FIG. 4 is a rear view of the Step Width Increaser being used at home by a “patient” with a rolling walker. The width of the separator being used in this photograph is approximately 2¾ inches (approximately 7 centimeters).

FIG. 5 is a side view of the Step Width Increaser being used at home by a “patient” with a rolling walker. The width of the separator being used in this photograph is approximately 2¾ inches (approximately 7 centimeters).

FIG. 6 is a front view of the Step Width Increaser being used at home by a “patient” with a rolling walker. The width of the separator being used in this photograph is approximately 2¾ inches (approximately 7 centimeters).

FIG. 7 is a rear view of the Step Width Increaser being used at home by a “patient” with a rolling walker. The width of the separator being used in this photograph is approximately 1½ inches (approximately 4 centimeters).

FIG. 8 is a front view of the Step Width Increaser being used at home by a “patient” with a rolling walker. The width of the separator being used in this photograph is approximately 1½ inches (approximately 4 centimeters).

OPERATION OF THE INVENTION

To use the apparatus, a user (e.g., a physical therapist) would connect the interlocking 2′ by 2′ mats together on the floor (or between the parallel bars) to provide the desired distance. Then, the step width separators are attached by Velcro® to the interlocking mats. The width of the separators used will be chosen by the physical therapist on a patient by patient basis. The patient will then line up at one end of the mat placing the left foot on the left side of the separator and the right foot on the right side of the separator (so the separator is between the patient's feet). Depending on the patient, he or she may have his or her wheelchair placed at one end of the mat and can be assisted to stand by the therapist. The patient's assistive device will then be given to the patient to use while keeping the feet separated by the step width separator. Use of a gait belt would also be recommended for this patient population during this gait training.

DETAILED DESCRIPTION OF THE INVENTION

The stability of the human body during gait depends on a stable base of support and step width. The step width of a normal gait is approximately 7-10 centimeters (or about 2¾-4 inches). The smaller the step width, the more unsteady a person's gait. Gait training with this apparatus can increase a patient's base of support, thus allowing gait with the minimum assistive device needed (or no assistive device).

Patients with neurological disorders (such as a stroke) or muscle weakness may need more than just exercises (such as strengthening of the hip abductors) to alleviate this problem. Some patients present with no step width during gait (inside of ankles—medial malleoli—actually rub together) or a scissoring gait pattern (when the patient's feet cross over each other during gait).

The apparatus will have “separators” of varying widths to monitor patient progress. The step width increaser separators will come in widths of approximately 2, 3, and 4 inches. This will enable patient progress to be measured (such as the patient reducing the separator width from 4 inches to 3 inches or 3 inches to 2 inches over time).

This invention is a device and method for monitoring and improving the mobility of patients with an unsteady gait due to a decreased step width. 

1. An apparatus for providing visual, tactile, and proprioceptive feedback to patients with a decreased step width (as determined by a physical therapist) due to a neurological disorder (e.g., increased tone of the lower extremity muscles such as the hip internal rotators and hip adductors or decreased muscle tone of the hip abductors) or profound lower extremity weakness due to disuse atrophy.
 2. An apparatus which is lightweight and portable allowing use in the patient's home by a physical therapist. This would enable the patient to receive gait training to increase step width in his or her home by a physical therapist as opposed to having to travel to a rehab unit or clinic for said training.
 3. An apparatus which will help increase a patient's step width and base of support. This will enable a patient to decrease the complexity of his or her assistive device (move from a walker to a 4 point cane, from a 4 point cane to a standard cane, etc.) or to regain the ability to walk without an assistive device at all. 